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                                                   Missouri Department of Revenue                                                         Department Use Only
                                         Form      Manufacturing Job Program Employers                                                    (MM/DD/YY)
                MO-MJP                             Withholding Report
                                                                                                                                                    Reporting Period
                                                                                                                                                    (MM/YY)

Missouri Tax I.D.                                                                                    Federal Employer
Number                                                                                               I.D. Number
                                         Name                                                             Owner Name                                 

                                         City                                                                                                                    State                                 Zip Code
        Business

Form MO-MJP must be submitted using the same frequency that you file Employer’s Return of Income Taxes Withheld (Form MO-941). 
Your completed Form MO-941 or proof of filing for electronic filers must accompany this form.  
1.   Enter the Department of Economic Development (DED) Project or Product Number assigned to each DED approved Manufacturing Jobs Program 
                                         jobs location and the facility address.
2.   Enter the amount of withholding tax retained at each facility address for this reporting period.  Use the back of this form.
3.   In Box A, enter the sum of the withholding tax retained from all DED approved locations.
4.   In Box B, enter the amount of withholding tax submitted on line one of Form MO-941 or the amount you electronically filed.
5.   In Box C, enter the sum of Boxes A and B.  This is the total amount of tax withheld from your employees.
6.   Sign this form, print your name, include a phone number, and e-mail address where you can be reached.
Important:
•   Form MO-941 should be completed after you have determined the amount of withholding tax you are allowed to retain and should only contain 
                                         the amount of withholding tax you are not allowed to retain.
•   Compensation on Form MO-941, Line 2 may be taken only on the amount of withholding tax you are not allowed to retain.
•   Submit Form MO-MJP at the same filing frequency and at the same time that you are required to submit Form MO-941.  For example, if you are a 
                                         monthly filer of Form MO-941, you must also complete Form MO-MJP on a monthly basis.  Even if you are allowed to retain 100% of your 
                                         withholding tax you must still complete and submit Form MO-941 showing $0.00 tax withheld.
•                                        If you did not retain the correct amount of tax prior to filing your original Form MO-941, you must amend your filing with a new Form MO-941 before 
                                         your Manufacturing Jobs claim will be accepted.                                                                        
                                         DED Project Or Product Number  Facility Address                                                                               Withholding Retained
                                                                                                                                                                       $
                                         DED Project Or Product Number  Facility Address                                                                               Withholding Retained
                                                                                                                                                                       $
                                         DED Project Or Product Number  Facility Address                                                                               Withholding Retained
                                                                                                                                                                       $
                                         DED Project Or Product Number  Facility Address                                                                               Withholding Retained
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                                         DED Project Or Product Number  Facility Address                                                                               Withholding Retained
                                                                                                                                                                       $
                                                                                                                                                                       A.
                Withholding Tax Retained                                                                                                                                                                       0.00
                                         Total amount retained for tax period .........................................................                                $
                                                                                                                                                                       B.
                                         Withholding tax liability from Line 1 of Form MO-941 (or amount electronically filed) .......................                 $
                                                                                                                                                               C. 
                                         Total amount of withholding tax for tax period (sum of boxes A and B) ..............................                          $                                       0.00

                                         Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
                                         Signature                                                   E-mail Address                                                        

                Signature                Printed Name                                                Phone Number                                                        Date (MM/DD/YYYY)
                                                                                                     (__ __ __) __ __ __ - __ __ __ __                                    __ __ /__ __ /__ __ __ __

                                                                                *14201010001*
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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DED Project Or Product Number Facility Address                              Withholding Retained
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                                                                                                0.00
Total amount retained this page                                             $
                                                                             Form MO-MJP (Revised 03-2015)
Mail to:  Taxation Division           Phone: (573) 751-5759
        P.O. Box 3375                 TTY: (800) 735-2966  Visit http://dor.mo.gov/taxcredit/
        Jefferson City, MO 65105-3375 Fax: (573) 522-6816   for additional information.
                                      E-mail:  withholdingproject@dor.mo.gov

                                      *14201020001*
                                               14201020001






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